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Individual

VERNON CLAUDE JESSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD LP

Contact information

Practice address
1185 TOWN CENTRE DR, SUITE 225, EAGAN, MN 55123-1186
(651) 769-6200
(651) 769-6249
Mailing address
2497 7TH AVE E, SUITE 101, NORTH ST. PAUL, MN 55109-2496
(651) 769-6437
(651) 769-6426

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP0884
MN

Other

Enumeration date
09/16/2006
Last updated
07/08/2007
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